Sunday, February 21, 2010

Three Types of Counseling Clients: Customers, Complainants and Visitors

Not everyone who comes for counseling wants help for themselves. Some come to complain about others, and some come to satisfy the mandate of their spouse, employer or the court. Job #1 for the counselor is to determine which type of client is in their office.

Customers really want help. They're motivated to grow and change or to figure out a solution for a complicated situation because they are in emotional and/or physical distress. They are experiencing uncomfortable symptoms that might indicate an emotional or mental disorder, grief or some type of transition. They WANT help, and they are willing to do almost anything the counselor recommends to alleviate their distress or to make progress through a relational or vocational dilemma. We counselors love to serve this type of client. Why? They cooperate with our purpose, which is to help people. Unfortunately, other types are not as easy.

Complainants come to counseling appointments to inform the counselor of all the bad things that their spouse, child or employer has done. "It's about time they get some help" is their not so subtle pronouncement when they enter the office. The point is usually lost on them that they might be part of the problem, either in the way that they are responding to their loved one (who isn't feeling their love), or because they actually precipitated the circumstance by some injurious attitude, words or behavior. The task of the counselor with complainants is to facilitate their catharsis with good-will and respect, while praying and waiting for them to indict themselves as part of the "identified client's" problems, or they invite the counselor to opine. "You've heard the way I see things. How do you see things?" Effective listening with sincerity and respect often earns the right to be heard. At that juncture it becomes possible to transition the "complainant" to a "customer" who is willing to work on something to help the "identified client", or to improve the situation.

Visitors are clients that have been mandated to attend counseling. Either their spouse, employer or a good friend has somehow given an ultimatum or leveraged them "to at least try counseling before you ________ (divorce, quit your job, continue your addiction, etc.)." The classic visitor sits mostly silent with arms crossed, daring the "shrink" to "get me to talk". This is where the psychologically trained professional earns the full fee. While a temptation is to refuse to play the game, compassion and discernment usually reveals that the visitor is scared. Why else would they respond to pressure of ultimatum? There must be something they fear worse than counseling, such as loss of relationship, job, or freedom (e.g., counseling in lieu of incarceration). Once that is discovered, it becomes possible to transition the visitor to the posture of a customer. There must be something they want. One of my most effective questions is this, "What's the least amount of change that _____ (the one that mandated counseling) wants to see that would get them off your back?" This makes possible the development of a therapeutic alliance with the visitor. Now you can start working on something together. The clients experiences the counselor as being in their corner. Once the objective they chose is satisfied, it is not uncommon for such clients to identify other objectives. "Hey, you helped me with that. Maybe you can help me with ____." That's pay-dirt in a therapeutic relationship; an invitation to be helpful.

Whether you are making a referral or going for counseling yourself, this taxonomy of clients can be helpful. When making a referral, consider how you see the client. Are they highly motivated and willing to take responsibility? Are they blind to their part of the situation, but willing to attend counseling with a loved one? Or are you having to cash in all your relational equity chips to get them to "go to counseling" or else lose their job or relationship with you? With the training above you can figure out which is which, and provide the receiving counselor with a bit more information that will help them to be effective.

God bless,


Tuesday, February 16, 2010

What do you mean they need counseling?

I wish I had a dollar for every time I've had a conversation like this:

"What do you do for a living?"

Me - "I'm a professional counselor. I help people that have mental or emotional disorders."

"Oh, I know someone who really needs your help."

Me - "Do they know it?"

"No, not really. How could we get them to see you? Will you call them?"

Me - "No."

"Why not?"

Me - "It really doesn't work very well for me to call people to tell them that they need help. They need to see it for themselves or to hear it from people that care for them. And, it needs to be concern in love, such as, 'I really care about you and I see you struggling with some difficult things in life right now. Would you consider seeing a professional to help you to understand what's happening and how to make things better?'"

"Oh, okay. Maybe I'll have that conversation. What's your number?"

Me - "Here's a card. I would be happy to talk with your friend briefly before even scheduling an appointment. Some people are pretty nervous about counseling. They fear that they're going to be diagnosed and told what's wrong with them, or like going to a Dr. that they're going to find out that they have a problem that can't be fixed. Sometimes meeting me briefly and hearing how I approach counseling can help to put them at ease enough that they are willing to schedule an appointment."

What it means when someone says, "They need counseling."

1. They care about someone that is going through a really hard and they don't know how to help them.

2. They see someone making bad decisions that are going to have negative consequences. They've tried to get them to stop, but haven't been successful.

3. They know someone that is very annoying or disruptive, but that person either doesn't know it or isn't willing to change.

Getting People to Counseling

1. Offer to go with them.

This is a highly effective way to get someone over the hump of anxiety about counseling, especially if they've never gone before. In addition to your comforting presence, you are conveying that they are worth your time and that their situation warrants your sacrifice.
2. Disclose that you once sought counseling and how it was helpful.
My list of client testimonies includes disclosure from a community leader about the benefits of my counseling for him and his entire family. It is really powerful and puts people at ease when high functioning people that are respected in the community normalize counseling as a ministry God has provided for the health and strengthening of the Body of Christ!

3. Promise to stay alongside as they go through the process.
I celebrate supportive pastors and friends that are willing to attend sessions, and spend extra time to listen and to encourage. At best, counseling catalyzed growth and change in person's life. In crisis, a client may have 2-3 hours of counseling each week (although 1 hour is more common). This is a very small fraction of the hours in a week (168). That's a lot of life to be lived between appointments. Those that continue to live in the midst of a supportive social and faith community get through their difficulties more quickly.

What do YOU mean, "They need counseling"?
The next time the thought crosses your mind, "They need counseling" think through it with these questions:

1. Why do I think that? What do I mean?

2. What outcome would I like to see or that I think is possible if they get effective counseling? What will be happening or won't be happening after they've been counseled effectively?

3. How can I help in the process? What role would God have me play in getting some help for them and/or supporting them in the process?

4. What would I want from friends, pastors, and others if I were going through a time like this?

When you think, "They need counseling" it's a pretty serious thought. Some disorders have mortality rate associated with them. And some life circumstances put otherwise normally functioning people at risk to commit suicide or homicide. And many people needlessly suffer prolonged bouts of depression and anxiety because they haven't had access to state of the art diagnosis and treatment. It's better to err on the side of caution by consulting with a professional about your concerns and how to get a person into treatment than to have something happen and live with regret.

Tuesday, February 9, 2010

How Grace and Truth was Born

How did Grace and Truth Counseling get its name?

In 2002 Jill and I perched on the precipice of a dream; our own Christian Counseling practice. The journey was long, beginning in 1987 with a Master's degree, 1990-91 for supplementary graduate classes (all the while practicing counseling in community mental health setting), and culminating with 30 more graduate hours in diagnosis and treatment between 1997-99. Finally! Sept 17, 1999 it was official, Jeffrey J. Williams, Professional Clinical Counselor, State of Ohio License, #E-0003098. Now what?

There was a bridge between 1999-2002 through a therapeutic Foster Care Agency, Lifeway for Youth (now Benchmark, Inc.). It was from there that Mike Berner, founder and CEO, graciously launched us into our dream. "It's been a blessing to have you here, but it is clear that it is time to go to do what you were made to do." Prophetically, Mike declared that what we were to do was more than we thought, but that launching a private practice was part of it. So, off we went...

"If you build it, they will come" was a frequent exhortation from friends, colleagues and former clients. "Don't worry about having enough business. You've been gifted to do this. You'll be fine." Still, rookie anxieties flooded my mind. "Do I have what it takes? "Will people really want to receive counseling from me and be willing to compensate me for it?"

After making the decision to establish a private practice, leasing an office and telling a few people, the question was, "What do we call it?" Boy, was that ever a prayerful challenge.

Fortuitously (and providentially), Jill and I were reading "Changes That Heal" by Henry Cloud, at the time. One of the first chapters of the book extensively discusses the Grace/Truth continuum based on John 1:14, "The Son of Man came full of grace and truth." Cloud's assertion was that while Jesus was the perfectly balanced embodiment of these two qualities, that the rest of us are apt to live on one side of the continuum more than the other. Diagnosis of our team of two was quick for Jill and me; she was grace and I was truth. Oops!

At the same time we were praying and discussing names for our counseling ministry. "What do you we want people to get from our ministry?" We discussed how dealing with reality of their lives, their choices and the circumstances in which they found themselves due to the choices of others was essential. "We have to deal with reality, even when it isn't pretty." "But, we also must compassionately hold them in kind, gentle, affirming relationship through which they will feel cared about and believed in." We believed that no one was beyond one beyond one destined to forever be a victim of their choices or circumstances. So, what do we call it?

Jesus is the most potent figure of history, we reasoned, exactly because He was full of both Grace and Truth. Ultimately we wanted our clients to receive Jesus, to experience Jesus, and in so much as we and our staff could embody grace and truth for our clients they WOULD receive Jesus in person, through our ministry to them. YES, that was it. We wanted to be like Him and embody Him in the way we interacted with them and the quality of input and ministry they received...Grace and Truth.

And now you know how Grace and Truth was born.

Grace - unmerited favor; not earned, and undeserved
Truth - the body of real things, events, facts

At Grace and Truth, "The Grace to try (again), and the truth to be successful."

Thursday, February 4, 2010

Perfect Storms: Why Everyone is Vulnerable to Clinical Depression , and what to do about it

By Jeff Williams, Supervising Professional Clinical Counselor*

Did you see the movie A Perfect Storm? If you did, you know that an otherwise sturdy commercial fishing boat and experienced crew was overcome (capsized and drowned) by a powerful combination of conditions that produced unprecedented weather conditions. It’s a tragic story that leaves the viewer unsettled because it seems that if that experienced crew and sturdy vessel could be overcome, then anyone could.

The same is true in each of our lives. If one could create the perfect combination of disappointments, discouragements and disillusioning experiences for a person’s life they will be hard-pressed to avoid a bout of clinical depression. Place anyone in an emotionally and psychologically overwhelming situation, and they are vulnerable to be overcome; to be capsized and left adrift in a stormy sea fighting to stay afloat.

Clinical Counselors look for three D’s when person says that they have been feeling depressed. These are questions you can ask yourself, your friends, employees, etc.

1. Disappointments – What has happened recently that disappointed you?
2. Discouragements – What has felt discouraging to you recently?
3. Disillusionments - What did you think was going to happen, but didn’t?

Answers to these questions provide clues to what a person has been experiencing and how they have been experiencing it. Now, how have these experiences affected them? Are they having difficulty functioning in their primary life roles? For adults this usually means as an employee at work and for youth it is usually as a student, at school.

What to do when D’s are discovered and functioning is compromised?
Forty percent of Americans will experience an episode of clinical depression at some point during their lifetime. Symptoms range from mild to severe and are usually debilitating to some extent as evidenced by compromised functioning at work, at school and/or at home. Symptoms include the following:

• Loss of interest in normal daily activities
• Feeling sad or down
• Feeling hopeless
• Crying spells for no apparent reason
• Problems sleeping
• Trouble focusing or concentrating
• Difficulty making decisions
• Unintentional weight gain or loss
• Irritability
• Restlessness
• Being easily annoyed
• Feeling fatigued or weak
• Feeling worthless
• Loss of interest in sex
• Thoughts of suicide or suicidal behavior
• Unexplained physical problems, such as back pain or headaches

Treatment options include talking therapy and medication. Sometimes both are necessary to alleviate symptoms.

If you or a loved one is experiencing the symptoms described above seek a professional’s perspective. It doesn’t mean that you are spiritually weak or sinful. You might just be responding very reasonably to overwhelming conditions.

I’ve chosen to write this first blog on the most common mental and emotional condition experienced by the general population. The bad news is that it is so prevalent. The good news is that good treatments exist and aren’t all that difficult to arrange.

Interested in exploring options or scheduling an appointment? Give us a call or write: 937.717.5591, or write,, or visit our website

* Jeffrey J. Williams is licensed as a Supervising Professional Clinical Counselor, E-000398 – SUPV (State of Ohio), license verification,